PREGNANCY AND LACTATION AFTER BREAST-CONSERVING THERAPY FOR EARLY-STAGE BREAST-CANCER

Background. To identify patients treated with breast conservation ther apy for early-stage breast cancer who subsequently experienced full-te rm pregnancies, and to identify: (1) The proportion of women who exper ienced lactation in the treated breast; and (2) treatment, disease, an d/or host factors that may be related to the presence or absence of la ctation and the ability to breast-feed successfully. Methods. The reco rds of 890 patients treated at the radiation therapy facilities of the Department of Therapeutic Radiology, Yale University, New Haven, CT, for early-stage (Stage I or II) breast cancer were reviewed to identif y patients who had become pregnant subsequent to completing breast con servation therapy. Data were collected from the patients' departmental records, and interviews were conducted by phone and/or questionnaire. Results. Thirteen patients were identified, and 11 patients who exper ienced 13 pregnancies were interviewed. All patients reported little o r no swelling of the treated breast during pregnancy. After delivery, lactation from the treated breast was present in four instances, absen t in six, and pharmacologically suppressed in three. One patient succe ssfully breast-fed from the treated breast for 4 months. In the majori ty of cases, breast-feeding from the untreated breast was successful. The interval from the time of treatment to the time of delivery did no t appear to affect adversely lactation from the treated breast; one pa tient reported lactation from the treated breast 75 months after compl etion of treatment. Circumareolar incision was associated with the abs ence of lactation in three patients (four pregnancies). Thus, lactatio n from the treated breast may be less likely to occur in the case of c entrally located lesions. Conclusion. Successful breast-feeding from t he untreated, as well as the treated breast, is possible after con-ser vative surgery and radiation. Implications for patients of child-beari ng age undergoing conservative surgery and radiation therapy are discu ssed.